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Diabetes care in humanitarian settings | Collections | MSF Science Portal

Diabetes affect hundreds of millions of people worldwide, a large majority of them living in low- and middle-income countries. Yet finding effective strategies, tools and policies for effectively managing this chronic illness—especially amid war, displacement or exclusion from care—is a neglected area of humanitarian medicine.

Here we present a cross-section of work on this front by MSF and collaborators. Several studies assess the shift towards community-based, nurse-led models of care in rural settings. Others explore obstacles to diabetes care for war refugees living in camps in Jordan or Lebanon, highlighting how health programs can adapt to their needs. The demonstration that insulin retains potency for 30 days if cooled without refrigeration is opening doors to more patient self-management, as a case study in remote South Sudan shows.

At the same time, MSF and others call for regulatory and financing policies that make diabetes medications and supplies cheaper, better adapted to humanitarian settings, and far more available to patients whose lives depend on them.

Collection Content

Journal Article
|
Research

Estimated sustainable cost-based prices for diabetes medicines

Barber MJ, Gotham D, Bygrave H, Cepuch C
2024-03-27 • JAMA Network Open
2024-03-27 • JAMA Network Open
IMPORTANCE
The burden of diabetes is growing worldwide. The costs associated with diabetes put substantial pressure on patients and health budgets, especially in low- and middle-inco...
Conference Material
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Poster

Evaluating task-sharing for non-communicable disease management in humanitarian settings: lessons learned from MSF’s model of care in Lebanon

Doumit M, Masri S, Beltran I, Incerti A, Ciglenecki I,  et al.
2023-06-07 • MSF Scientific Day International 2023
2023-06-07 • MSF Scientific Day International 2023
Journal Article
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Commentary

A framework for improving diabetes care in humanitarian emergencies

Kehlenbrink S, Jobanputra K, International Alliance for Diabetes Action
2023-03-01 • Lancet Diabetes and Endocrinology
2023-03-01 • Lancet Diabetes and Endocrinology
Conference Material
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Poster

Recurrent DKA reduced by home glucose monitoring and clay pot insulin storage in a low resource setting - a case report

Simon M, Seignoux J, Fadumiyo A, Muderhwa Y
2022-11-30 • MSF Paediatric Days 2022
2022-11-30 • MSF Paediatric Days 2022
Conference Material
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Poster

Decentralization of insulin treatment through nurses and clinical officers in nine health centres in a rural county, Kenya: descriptive study

Borum Mølskov Bech M, Otieno Khisa A, Ndoca K, Ayuaya T, Kajuju P,  et al.
2022-05-09 • MSF Scientific Days International 2022
2022-05-09 • MSF Scientific Days International 2022
Journal Article
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Letter

Diabetes and the WHO model list of essential medicines

Reddy A
2022-01-01 • Lancet Diabetes and Endocrinology
2022-01-01 • Lancet Diabetes and Endocrinology
Journal Article
|
Research

MSF experiences of providing multidisciplinary primary level NCD care for Syrian refugees and the host population in Jordan: an implementation study guided by the RE-AIM framework

Ansbro É, Homan T, Qasem J, Bil K, Tarawneh M,  et al.
2021-04-26 • BMC Health Services Research
2021-04-26 • BMC Health Services Research
BACKGROUND
In response to the rising global NCD burden, humanitarian actors have rapidly scaled-up NCD services in crisis-affected low-and-middle income countries. Using the RE-AIM i...
Journal Article
|
Review

Operational considerations for the management of non-communicable diseases in humanitarian emergencies

Bausch FJ, Beran D, Hering H, Boulle P, Chappuis F,  et al.
2021-02-25 • Conflict and Health
2021-02-25 • Conflict and Health
Non-communicable diseases (NCD) represent an increasing global challenge with the majority of mortality occurring in low- and middle-income countries (LMICs). Concurrently, many humanita...
Journal Article
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Research

Heat-stability study of various insulin types in tropical temperature conditions: new insights towards improving diabetes care

Kaufmann B, Boulle P, Berthou F, Fournier M, Beran D,  et al.
2021-02-03 • PLOS One
2021-02-03 • PLOS One
Strict storage recommendations for insulin are difficult to follow in hot tropical regions and even more challenging in conflict and humanitarian emergency settings, adding an extra burd...
Journal Article
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Research

Setting up a nurse-led model of care for management of hypertension and diabetes mellitus in a high HIV prevalence context in rural Zimbabwe: a descriptive study

Frieden M, Zamba B, Mukumbi N, Mafaune PT, Makumbe B,  et al.
2020-06-01 • BMC Health Services Research
2020-06-01 • BMC Health Services Research
BACKGROUND
In the light of the increasing burden of non-communicable diseases (NCDs) on health systems in low- and middle-income countries, particularly in Sub-Saharan Africa, contex...

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Adapting essential care programs to Covid-19 pandemic times
Adapting essential care programs to Covid-19 pandemic times
As the ongoing Covid-19 pandemic grips the world, one of its most devastating indirect effects is the disruption to medical services for preventing and treating other life-threatening diseases—especially in countries with already-fragile health systems. For MSF and other global health actors this means not only responding to Covid-19 directly but also assessing its impact on other essential care and then adapting programs so they can keep serving patients despite the enormous obstacles. In this Collection you will find a selection of published articles and conference content from this year’s MSF Scientific Days 2021 conference content, encompassing a range of approaches, settings and medical challenges—from malaria, TB and HIV/AIDS prevention and care to digital health promotion and sexual and reproductive health.
New tools and approaches to drug-resistant TB
New tools and approaches to drug-resistant TB
The World Health Organization estimates that 410,000 people developed a drug-resistant tuberculosis infection (DR-TB) in 2022, only 40% of whom were diagnosed and started on treatment—and only 63% then cured. Given all these points of failure, innovation in preventing, diagnosing and treating DR-TB cannot come fast enough. To mark World TB Day (24 March 2024) the content collection linked below highlights recent work by MSF and collaborators to help change this grim picture. The TB-PRACTECAL and endTB studies delivered robust evidence for shorter, safer, more effective drug regimens that are already saving lives worldwide. Other studies explore new approaches to preventive treatment and simpler, quicker, accurate detection of TB and drug resistance—especially among difficult-to-diagnose populations such as children and people living with HIV. But to impact DR-TB globally these innovations must become widely accessible. This requires changes on many fronts, as described in an accompanying Collection (Expanding Access to Lifesaving New TB Tools).
The climate crisis and health in humanitarian settings
The climate crisis and health in humanitarian settings
The climate crisis is also a health and humanitarian crisis, disproportionately impacting people in the world’s most climate-sensitive regions—mainly low- and low-middle income countries with the least capacity to respond. MSF and other humanitarian organizations witness the consequences daily. More frequent, intense weather events and a warming planet contribute to food and water scarcity, more severe and widespread disease outbreaks, and more injuries and preventable deaths. They also drive massive population displacement, with over 32 million people fleeing their homes in 2022 alone due to floods, drought, storms and fire—nearly triple the number displaced by violence and conflict. To mark Earth Day 2024 (22 April) we present a cross-section of work by MSF and collaborators, drawing from a range of data sources and from first-hand experience at our medical projects. Emphasizing the urgency of adapting humanitarian operations to the climate crisis, the collection also explores loss and damage through a health lens, proposes policies and practices for creating climate-resilient health organizations, and advocates for embedding fair, just ethics perspectives into humanitarian action and research on climate.
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Diabetes care in humanitarian settings

Diabetes care in humanitarian settings